Healthcare Provider Details

I. General information

NPI: 1124066444
Provider Name (Legal Business Name): BRIAN J VANHOOSE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 06/07/2023
Certification Date: 06/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SAINT CHRISTOPHER DR EMERGENCY DEPARTMENT
ASHLAND KY
41101-7034
US

IV. Provider business mailing address

19217 BEAR CREEK RD
CATLETTSBURG KY
41129-9230
US

V. Phone/Fax

Practice location:
  • Phone: 606-833-3333
  • Fax: 260-407-8004
Mailing address:
  • Phone: 606-929-9592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number29737
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number29737
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: